BILL NUMBER: SB 929	CHAPTERED  09/26/00

	CHAPTER   676
	FILED WITH SECRETARY OF STATE   SEPTEMBER 26, 2000
	APPROVED BY GOVERNOR   SEPTEMBER 24, 2000
	PASSED THE SENATE   AUGUST 30, 2000
	PASSED THE ASSEMBLY   AUGUST 28, 2000
	AMENDED IN ASSEMBLY   AUGUST 24, 2000
	AMENDED IN ASSEMBLY   JUNE 21, 2000
	AMENDED IN SENATE   JANUARY 4, 2000

INTRODUCED BY   Senator Polanco
   (Principal coauthor: Assembly Member Baugh)
   (Coauthors: Senators Alarcon, Haynes, Johnson, Karnette, Lewis,
Morrow, Ortiz, Rainey, and Solis)
   (Coauthors: Assembly Members Aanestad, Alquist, Aroner, Ashburn,
Baldwin, Firebaugh, Gallegos, Honda, Keeley, Maddox, Romero,
Steinberg, Strickland, Vincent, and Washington)

                        FEBRUARY 25, 1999

   An act to amend Sections 2544, 3041, and 3059 of, and to repeal
Section 3041.1 of, the Business and Professions Code, and to amend
Sections 11024, 11026, 11150, and 11210 of the Health and Safety
Code, relating to optometry.



	LEGISLATIVE COUNSEL'S DIGEST


   SB 929, Polanco.  Optometry.
   (1) Existing law provides that a technician in the office of a
physician or an optometrist may fit prescription lenses.
   This bill would instead refer to an assistant and would set forth
additional duties that an assistant may perform under the direct
responsibility and supervision of an ophthalmologist or optometrist.

   (2) Under existing law, the practice of optometry includes, among
other things, the examination of the human eye or eyes, or its or
their appendages, and the analysis of the human vision system, either
subjectively or objectively, and the use of pharmaceutical agents
for the sole purpose of the examination of the human eye or eyes for
any disease or pathological condition.  Existing law allows certified
optometrists to diagnose and treat certain conditions of the human
eye or its appendages, and use therapeutic pharmaceutical agents to
do so.  The State Board of Optometry, with the advice and consent of
the Division of Allied Health Professionals of the Medical Board of
California, is also authorized to designate the specific topical
pharmaceutical agents to be used for these purposes.
   This bill would provide that the practice of optometry also
includes the prevention, diagnosis, treatment, management, and
rehabilitation of disorders and dysfunctions of the visual system.
This bill changes a number of the identified conditions that
certified optometrists may diagnose and treat, and requires
consultation or referral to an ophthalmologist under certain
circumstances, as specified.  This bill would also make changes to
the list of topical pharmaceutical agents that may be used for these
purposes, and requires optometrists to again refer or consult with
ophthalmologists under certain circumstances, as specified.  In any
case where the bill requires an optometrist to consult with an
ophthalmologist, the optometrist is required to maintain a written
record in the patient's file and furnish a copy upon request by the
consulting ophthalmologist, and this bill would specify that all
collaborations, consultations, and referrals be made to an
ophthalmologist located geographically appropriate to the patient.
The bill would also provide for certification of optometrists to
treat primary open angle glaucoma in patients over the age of 18 if
certain requirements are met.
   (3) Existing law provides for a Therapeutic Pharmaceutical Agent
Advisory Committee within the State Board of Optometry to consist of
6 members, 3 of whom are appointed by the Medical Board of
California, and 3 of whom are appointed by the State Board of
Optometry, as specified.
   This bill would abolish that committee.
   (4) Existing law imposes education and training requirements in
order for an optometrist to obtain certification for the use of
therapeutic pharmaceutical agents and requires the board to issue a
certificate to those applicants meeting the prescribed criteria.  It
requires certificate holders to complete a minimum of 50 hours of
continuing education every 2 years if legislation is enacted that
requires the licensure of optometrists on a 2-year renewal cycle, and
requires, if legislation is not enacted, a minimum of 25 hours of
continuing education every year.
   This bill would require certificate holders to complete a minimum
of 50 hours of continuing education every 2 years in order to renew
their certification, with 35 of those hours being designated for
training on particular conditions or diseases, as specified.
   (5) This bill would also express the intent of the Legislature
that the law governing the scope of the practice of optometry not be
amended prior to January 1, 2009, and that no legislation to this
effect be introduced prior to January 1, 2008, with parties
interested in this matter to commence negotiations no later than
January 1, 2007, on any proposed changes to the scope of this
practice.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  Nothing in this act shall be construed to limit the
scope of practice of an optometrist as it existed prior to the
effective date of this act.
  SEC. 2.  Section 2544 of the Business and Professions Code is
amended to read:
   2544.  An assistant in the office of a physician and surgeon or
optometrist acting under the direct responsibility and supervision of
the physician and surgeon or optometrist may fit prescription
lenses.  Under the direct responsibility and supervision of the
ophthalmologist or optometrist, an assistant in the office of an
ophthalmologist or optometrist may also do the following:
   (a) Prepare patients for examination.
   (b) Collect preliminary patient data, including taking a patient
history.
   (c) Perform simple noninvasive testing of visual acuity, pupils,
and ocular motility.
   (d) Perform automated visual field testing.
   (e) Perform ophthalmic photography and digital imaging.
   (f) Perform tonometry.
   (g) Perform lensometry.
   (h) Perform nonsubjective auto refraction in connection with
subjective refraction procedures performed by an ophthalmologist or
optometrist.
   (i) Administer cycloplegiacs, mydriatics, and topical anesthetics
that are not controlled substances, for ophthalmic purposes.
   (j) Perform pachymetry, keratometry, A scans, B scans, and
electrodiagnostic testing.
  SEC. 3.  Section 3041 of the Business and Professions Code is
amended to read:
   3041.  (a) The practice of optometry includes the prevention and
diagnosis of disorders and dysfunctions of the visual system, and the
treatment and management of certain disorders and dysfunctions of
the visual system, as well as the provision of rehabilitative
optometric services, and is the doing of any or all of the following:

   (1) The examination of the human eye or eyes, or its or their
appendages, and the analysis of the human vision system, either
subjectively or objectively.
   (2) The determination of the powers or range of human vision and
the accommodative and refractive states of the human eye or eyes,
including the scope of its or their functions and general condition.

   (3) The prescribing or directing the use of, or using, any optical
device in connection with ocular exercises, visual training, vision
training, or orthoptics.
   (4) The prescribing of contact and spectacle lenses for, or the
fitting or adaptation of contact and spectacle lenses to, the human
eye, including lenses which may be classified as drugs or devices by
any law of the United States or of this state.
   (5) The use of topical pharmaceutical agents for the sole purpose
of the examination of the human eye or eyes for any disease or
pathological condition.  The topical pharmaceutical agents shall
include mydriatics, cycloplegics, anesthetics, and agents for the
reversal of mydriasis.
   (b) (1) An optometrist who is certified to use therapeutic
pharmaceutical agents, pursuant to Section 3041.3, may also diagnose
and exclusively treat the human eye or eyes, or any of its
appendages, for all of the following conditions:
   (A) Through medical treatment, infections of the anterior segment
and adnexa, excluding the lacrimal gland, the lacrimal drainage
system and the sclera.  Nothing in this section shall authorize any
optometrist to treat a person with AIDS for ocular infections.
   (B) Ocular allergies of the anterior segment and adnexa.
   (C) Ocular inflammation, nonsurgical in cause, limited to
inflammation resulting from traumatic iritis, peripheral corneal
inflammatory keratitis, episcleritis, and unilateral nonrecurrent
nongranulomatous idiopathic iritis in patients over the age of 18.
Unilateral nongranulomatous idiopathic iritis recurring within one
year of the initial occurrence shall be referred to an
ophthalmologist.  An optometrist shall consult with an
ophthalmologist if a patient has a recurrent case of episcleritis
within one year of the initial occurrence.  An optometrist shall
consult with an ophthalmologist if a patient has a recurrent case of
peripheral corneal inflammatory keratitis within one year of the
initial occurrence.
   (D) Traumatic or recurrent conjunctival or corneal abrasions and
erosions.
   (E) Corneal surface disease and dry eyes.
   (F) Ocular pain, not related to surgery, associated with
conditions optometrists are authorized to treat.
   (G) Pursuant to subdivision (f), primary open angle glaucoma in
patients over the age of 18.
   (2) For purposes of this section, "treat" means the use of
therapeutic pharmaceutical agents, as described in subdivision (c),
and the procedures described in subdivision (e).
   (c) In diagnosing and treating the conditions listed in
subdivision (b), an optometrist certified to use therapeutic
pharmaceutical agents pursuant to Section 3041.3, may use all of the
following therapeutic  pharmaceutical agents exclusively:
   (1) All of the topical pharmaceutical agents listed in paragraph
(5) of subdivision (a) as well as topical miotics for diagnostic
purposes.
   (2) Topical lubricants.
   (3) Topical antiallergy agents.  In using topical steroid
medication for the treatment of ocular allergies, an optometrist
shall do the following:
   (A) Consult with an ophthalmologist if the patient's condition
worsens 72 hours after diagnosis.
   (B) Consult with an ophthalmologist if the inflammation is still
present three weeks after diagnosis.
   (C) Refer the patient to an ophthalmologist if the patient is
still on the medication six weeks after diagnosis.
   (D) Refer the patient to an ophthalmologist if the patient's
condition recurs within three months.
   (4) Topical antiinflammatories.  In using topical steroid
medication for:
   (A) Unilateral nonrecurrent nongranulomatous idiopathic iritis or
episcleritis, an optometrist shall consult with an ophthalmologist if
the patient's condition worsens 72 hours after the diagnosis, or if
the patient's condition has not resolved three weeks after diagnosis.
  If the patient is still receiving medication for these conditions
six weeks after diagnosis, the optometrist shall refer the patient to
an ophthalmologist.
   (B) Peripheral corneal inflammatory keratitis, excluding Moorens
and Terriens diseases, an optometrist shall consult with an
ophthalmologist if the patient's condition worsens 48 hours after
diagnosis.  If the patient is still receiving the medication two
weeks after diagnosis, the optometrist shall refer the patient to an
ophthalmologist.
   (C) Traumatic iritis, an optometrist shall consult with an
ophthalmologist if the patient's condition worsens 72 hours after
diagnosis and shall refer the patient to an ophthalmologist if the
patient's condition has not resolved one week after diagnosis.
   (5) Topical antibiotic agents.
   (6) Topical hyperosmotics.
   (7) Topical antiglaucoma agents pursuant to the certification
process defined in subdivision (f).
   (A) The optometrist shall not use more than two concurrent topical
medications in treating the patient for primary open angle glaucoma.
  A single combination medication that contains two pharmacological
agents shall be considered as two medications.
   (B) The optometrist shall refer the patient to an ophthalmologist
if requested by the patient, if treatment goals are not achieved with
the use of two topical medications or if indications of narrow angle
or secondary glaucoma develop.
   (C) If the glaucoma patient also has diabetes, the optometrist
shall consult in writing with the physician treating the patient's
diabetes in developing the glaucoma treatment plan and shall notify
the physician in writing of any changes in the patient's glaucoma
medication.  The physician shall provide written confirmation of such
consultations and notifications.
   (8) Nonprescription medications used for the rational treatment of
an ocular disorder.
   (9) Oral antihistamines.  In using oral antihistamines for the
treatment of ocular allergies, the optometrist shall refer the
patient to an ophthalmologist if the patient's condition has not
resolved two weeks after diagnosis.
   (10) Prescription oral nonsteroidal antiinflammatory agents.  The
agents shall be limited to three  days' use.  If the patient's
condition has not resolved three days after diagnosis, the
optometrist shall refer the patient to an ophthalmologist.
   (11) The following oral antibiotics for medical treatment as set
forth in subparagraph (A) of paragraph (1) of subdivision (b):
tetracyclines, dicloxacillin, amoxicillin, amoxicillin with
clavulanate, erythromycin, clarythromycin, cephalexin, cephadroxil,
cefaclor, trimethoprim with sulfamethoxazole, ciprofloxacin, and
azithromycin.  The use of azithromycin shall be limited to the
treatment of eyelid infections and chlamydial disease manifesting in
the eyes.
   (A) If the patient has been diagnosed with a central corneal ulcer
and the condition has not improved 24 hours after diagnosis, the
optometrist shall consult with an ophthalmologist.  If the central
corneal ulcer has not improved 48 hours after diagnosis, the
optometrist shall refer the patient to an ophthalmologist.  If the
patient is still receiving antibiotics 10 days after diagnosis, the
optometrist shall refer the patient to an ophthalmologist.
   (B) If the patient has been diagnosed with preseptal cellulitis or
dacryocystitis and the condition has not improved 72 hours after
diagnosis, the optometrist shall refer the patient to an
ophthalmologist.  If a patient with preseptal cellulitis or
dacryocystitis is still receiving oral antibiotics 10 days after
diagnosis, the optometrist shall refer the patient to an
ophthalmologist.
   (C) If the patient has been diagnosed with blepharitis and the
patient's condition does not improve after six weeks of treatment,
the optometrist shall consult with an ophthalmologist.
   (D) For the medical treatment of all other medical conditions as
set forth in subparagraph (A) of paragraph (1) of subdivision (b), if
the patient's condition worsens 72 hours after diagnosis, the
optometrist shall consult with an ophthalmologist.  If the patient's
condition has not resolved 10 days after diagnosis, the optometrist
shall refer the patient to an ophthalmologist.
   (12) Topical antiviral medication and oral acyclovir for the
medical treatment of the following:  herpes simplex viral keratitis,
herpes simplex viral conjunctivitis and periocular herpes simplex
viral dermatitis; and varicella zoster viral keratitis, varicella
zoster viral conjunctivitis and periocular varicella zoster viral
dermatitis.
   (A) If the patient has been diagnosed with herpes simplex
keratitis or varicella zoster viral keratitis and the patient's
condition has not improved seven days after diagnosis, the
optometrist shall refer the patient to an ophthalmologist.  If a
patient's condition has not resolved three weeks after diagnosis, the
optometrist shall refer the patient to an ophthalmologist.
   (B) If the patient has been diagnosed with herpes simplex viral
conjunctivitis, herpes simplex viral dermatitis, varicella zoster
viral conjunctivitis or varicella zoster viral dermatitis, and if the
patient's condition worsens seven days after diagnosis, the
optometrist shall consult with an ophthalmologist.  If the patient's
condition has not resolved three weeks after diagnosis, the
optometrist shall refer the patient to an ophthalmologist.
   (C) In all cases, the use of topical antiviral medication shall be
limited to three weeks, and the use of oral acyclovir shall be
limited to 10 days.
   (13) Oral analgesics that are not controlled substances.
   (14) Codeine with compounds and hydrocodone with compounds as
listed in the California Uniform Controlled Substances Act (Section
11000 of the Health and Safety Code et seq.) and the United States
Uniform Controlled Substances Act (21 U.S.C. Sec. 801 et seq.).  The
use of these agents shall be limited to three days, with a referral
to an ophthalmologist if the pain persists.
   (d) In any case where this chapter requires that an optometrist
consult with an ophthalmologist, the optometrist shall maintain a
written record in the patient's file of the information provided to
the ophthalmologist, the ophthalmologist's response and any other
relevant information.  Upon the consulting ophthalmologist's request,
the optometrist shall furnish a copy of the record to the
ophthalmologist.
   (e) An optometrist who is certified to use therapeutic
pharmaceutical agents pursuant to Section 3041.3 may also perform all
of the following:
   (1) Mechanical epilation.
   (2) Ordering of smears, cultures, sensitivities, complete blood
count, mycobacterial culture, acid fast stain, and urinalysis.
   (3) Punctal occlusion by plugs, excluding laser, cautery,
diathermy, cryotherapy, or other means constituting surgery as
defined in this chapter.
   (4) The prescription of therapeutic contact lenses.
   (5) Removal of foreign bodies of the cornea, eyelid, and
conjunctiva.  Corneal foreign bodies shall be nonperforating, be no
deeper than the anterior stroma, and require no surgical repair upon
removal.  Within the central three millimeters of the cornea, the use
of sharp instruments is prohibited.
   (6) For patients over the age of 12 years, lacrimal irrigation and
dilation, excluding probing of the nasal lacrimal tract.  The State
Board of Optometry shall certify an optometrist to perform this
procedure after completing 10 of the procedures under the supervision
of an ophthalmologist as confirmed by the ophthalmologist.
   (7) No injections other than the use of an auto-injector to
counter anaphylaxis.
   (f) The State Board of Optometry shall grant a certificate to an
optometrist certified pursuant to Section 3041.3 for the treatment of
primary open angle glaucoma in patients over the age of 18 only
after the optometrist meets the following requirements:
   (1) Satisfactory completion of a didactic course of not less than
24 hours in the diagnosis, pharmacological and other treatment and
management of glaucoma.  The 24-hour glaucoma curriculum shall be
developed by an accredited California school of optometry.  Any
applicant who graduated from an accredited California school of
optometry on or after May 1, 2000, shall be exempt from the 24-hour
didactic course requirement contained in this paragraph.
   (2) After completion of the requirement contained in paragraph
(1), collaborative treatment of 50 glaucoma patients for a period of
two years for each patient under the following terms:
   (A) After the optometrist makes a provisional diagnosis of
glaucoma, the optometrist and the patient shall identify a
collaborating ophthalmologist.
   (B) The optometrist shall develop a treatment plan that considers
for each patient target intraocular pressures, optic nerve appearance
and visual field testing for each eye, and an initial proposal for
therapy.
   (C) The optometrist shall transmit relevant information from the
examination and history taken of the patient along with the treatment
plan to the collaborating ophthalmologist.  The collaborating
ophthalmologist shall confirm or refute the glaucoma diagnosis within
30 days.  To accomplish this, the collaborating ophthalmologist
shall perform a physical examination of the patient.
   (D) Once the collaborating ophthalmologist confirms the diagnosis
and approves the treatment plan in writing, the optometrist may begin
treatment.
   (E) The optometrist shall use no more than two concurrent topical
medications in treating the patient for glaucoma.  A single
combination medication that contains two pharmacologic agents shall
be considered as two medications.  The optometrist shall notify the
collaborating ophthalmologist in writing if there is any change in
the medication used to treat the patient for glaucoma.
   (F) Annually after commencing treatment, the optometrist shall
provide a written report to the collaborating ophthalmologist about
the achievement of goals contained in the treatment plan.  The
collaborating ophthalmologist shall acknowledge receipt of the report
in writing to the optometrist within 10 days.
   (G) The optometrist shall refer the patient to an ophthalmologist
if requested by the patient, if treatment goals are not achieved with
the use of two topical medications, or if indications of secondary
glaucoma develop.  At his or her discretion, the collaborating
ophthalmologist may periodically examine the patient.
   (H) If the glaucoma patient also has diabetes, the optometrist
shall consult in writing with the physician treating the patient's
diabetes in preparation of the treatment plan and shall notify the
physician in writing if there is any change in the patient's glaucoma
medication.  The physician shall provide written confirmation of the
consultations and notifications.
   (I) The optometrist shall provide the following information to the
patient in writing:  nature of the working or suspected diagnosis,
consultation evaluation by a collaborating ophthalmologist, treatment
plan goals, expected followup care, and a description of the
referral requirements.  The document containing the information shall
be signed and dated by both the optometrist and the ophthalmologist
and maintained in their files.
   (3) When the requirements contained in paragraphs (1) and (2) have
been satisfied, the optometrist shall submit proof of completion to
the State Board of Optometry and apply for a certificate to treat
primary open angle glaucoma.  That proof shall include corroborating
information from the collaborating ophthalmologist.  If the
ophthalmologist fails to respond within 60 days of a request for
information from the State Board of Optometry, the board may act on
the optometrist's application without that corroborating information.

   (4) After an optometrist has treated a total of 50 patients for a
period of two years each and has received certification from the
State Board of Optometry, the optometrist may treat the original 50
collaboratively treated patients independently, with the written
consent of the patient.  However, any glaucoma patients seen by the
optometrist before the two-year period has expired for each of the 50
patients shall be treated under the collaboration protocols
described in this section.
   (g) Notwithstanding any other provision of law, an optometrist
shall not treat children under one year of age with therapeutic
pharmaceutical agents.
   (h) Any dispensing of a therapeutic pharmaceutical agent by an
optometrist shall be without charge.
   (i) Notwithstanding any other provision of law, the practice of
optometry does not include performing surgery.  "Surgery" means any
procedure in which human tissue is cut, altered, or otherwise
infiltrated by mechanical or laser means in a manner not specifically
authorized by this act.  Nothing in the act amending this section
shall limit an optometrist's authority, as it existed prior to the
effective date of the act amending this section, to utilize
diagnostic laser and ultrasound technology.
   (j) All collaborations, consultations, and referrals made by an
optometrist pursuant to this section shall be to an ophthalmologist
located geographically appropriate to the patient.
  SEC. 4.  Section 3041.1 of the Business and Professions Code is
repealed.
  SEC. 5.  Section 3059 of the Business and Professions Code is
amended to read:
   3059.  (a) It is the intent of the Legislature that the public
health and safety would be served by requiring all holders of
licenses to practice optometry granted under this chapter to continue
their education after receiving their licenses.  The board shall
adopt regulations that require, as a condition to the renewal
thereof, that all holders of licenses submit proof satisfactory to
the board that they have informed themselves of the developments in
the practice of optometry occurring since the original issuance of
their licenses by pursuing one or more courses of study satisfactory
to the board or by other means deemed equivalent by the board.
   (b) The board may, in accordance with the intent of this section,
make exceptions from continuing education requirements for reasons of
health, military service, or other good cause.
   (c) If for good cause compliance cannot be met for the current
year, the board may grant exemption of compliance for that year,
provided that a plan of future compliance that includes current
requirements as well as makeup of previous requirements is approved
by the board.
   (d) The board may require that proof of compliance with this
section be submitted on an annual or biennial basis as determined by
the board.
   (e) The board may adopt regulations to require licensees to
maintain current certification in cardiopulmonary resuscitation.
Training required for the granting or renewal of a cardiopulmonary
certificate shall not be credited towards the requirements of
subdivision (a) or (f).
   (f) An optometrist certified to use therapeutic pharmaceutical
agents pursuant to Section 3041.3 shall complete a total of 50 hours
of continuing education every two years in order to renew his or her
certificate.  Thirty-five of the required 50 hours of continuing
education shall be on the diagnosis, treatment, and management of
ocular disease as follows:  12 hours on glaucoma, 10 hours on ocular
infections; five hours on inflammation and topical steroids; six
hours on systemic medications and two hours on the use of pain
medications.
   (g) The board shall encourage every optometrist to take a course
or courses in pharmacology and pharmaceuticals as part of his or her
continuing education.
   (h) The board shall consider requiring courses in child abuse
detection to be taken by those licensees whose practices are such
that there is a likelihood of contact with abused or neglected
children.
   (i) The board shall consider requiring courses in elder abuse
detection to be taken by those licensees whose practices are such
that there is a likelihood of contact with abuse or neglected elder
persons.
  SEC. 6.  Section 11024 of the Health and Safety Code is amended to
read:
   11024.  "Physician," "dentist," "podiatrist," "pharmacist,"
"veterinarian," and "optometrist" means persons who are licensed to
practice their respective professions in this state.
  SEC. 7.  Section 11026 of the Health and Safety Code is amended to
read:
   11026.  "Practitioner" means any of the following:
   (a) A physician, dentist, veterinarian, podiatrist, or pharmacist
acting within the scope of a project authorized under Article 1
(commencing with Section 128125) of Chapter 3 of Part 3 of Division
107, a registered nurse acting within the scope of a project
authorized under Article 1 (commencing with Section 128125) of
Chapter 3 of Part 3 of Division 107, a nurse practitioner acting
within the scope of Section 2836.1 of the Business and Professions
Code, or a physician assistant acting within the scope of a project
authorized under Article 1 (commencing with Section 128125) of
Chapter 3 of Part 3 of Division 107 or Section 3502.1 of the Business
and Professions Code, or an optometrist acting within the scope of
Section 3041 of the Business and Professions Code.
   (b) A pharmacy, hospital, or other institution licensed,
registered, or otherwise permitted to distribute, dispense, conduct
research with respect to or to administer a controlled substance in
the course of professional practice or research in this state.
   (c) A scientific investigator, or other person licensed,
registered, or otherwise permitted, to distribute, dispense, conduct
research with respect to, or administer, a controlled substance in
the course of professional practice or research in this state.
  SEC. 8.  Section 11150 of the Health and Safety Code is amended to
read:
   11150.  No person other than a physician, dentist, podiatrist, or
veterinarian, or pharmacist acting within the scope of a project
authorized under Article 1 (commencing with Section 128125) of
Chapter 3 of Part 3 of Division 107, a registered nurse acting within
the scope of a project authorized under Article 1 (commencing with
Section 128125) of Chapter 3 of Part 3 of Division 107, a nurse
practitioner acting within the scope of Section 2836.1 of the
Business and Professions Code, a physician assistant acting within
the scope of a project authorized under Article 1 (commencing with
Section 128125) of Chapter 3 of Part 3 of Division 107 or Section
3502.1 of the Business and Professions Code, or an optometrist acting
within the scope of Section 3041 of the Business and Professions
Code, or an out-of-state prescriber acting pursuant to Section 4005
of the Business and Professions Code shall write or issue a
prescription.
  SEC. 9.  Section 11210 of the Health and Safety Code is amended to
read:
   11210.  A physician, surgeon, dentist, veterinarian, or
podiatrist, or pharmacist acting within the scope of a project
authorized under Article 1 (commencing with Section 128125) of
Chapter 3 of Part 3 of Division 107, or registered nurse acting
within the scope of a project authorized under Article 1 (commencing
with Section 128125) of Chapter 3 of Part 3 of Division 107, or
physician assistant acting within the scope of a project authorized
under Article 1 (commencing with Section 128125) of Chapter 3 of Part
3 of Division 107, or an optometrist acting within the scope of
Section 3041 of the Business and Professions Code may prescribe for,
furnish to, or administer controlled substances to his or her patient
when the patient is suffering from a disease, ailment, injury, or
infirmities attendant upon old age, other than addiction to a
controlled substance.
   The physician, surgeon, dentist, veterinarian, or podiatrist, or
pharmacist acting within the scope of a project authorized under
Article 1 (commencing with Section 128125) of Chapter 3 of Part 3 of
Division 107, or registered nurse acting within the scope of a
project authorized under Article 1 (commencing with Section 128125)
of Chapter 3 of Part 3 of Division 107, or physician assistant acting
within the scope of a project authorized under Article 1 (commencing
with Section 128125) of Chapter 3 of Part 3 of Division 107, or an
optometrist acting within the scope of Section 3041 of the Business
and Professions Code shall prescribe, furnish, or administer
controlled substances only when in good faith he or she believes the
disease, ailment, injury, or infirmity requires the treatment.
   The physician, surgeon, dentist, veterinarian, or podiatrist, or
pharmacist acting within the scope of a project authorized under
Article 1 (commencing with Section 128125) of Chapter 3 of Part 3 of
Division 107, or registered nurse acting within the scope of
                                    a project authorized under
Article 1 (commencing with Section 128125) of Chapter 3 of Part 3 of
Division 107, or physician assistant acting within the scope of a
project authorized under Article 1 (commencing with Section 128125)
of Chapter 3 of Part 3 of Division 107, or an optometrist acting
within the scope of Section 3041 of the Business and Professions Code
shall prescribe, furnish, or administer controlled substances only
in the quantity and for the length of time as are reasonably
necessary.
  SEC. 10.  It is the intent of the Legislature that the law
governing the scope of practice of optometry shall not be amended
prior to January 1, 2009, and that no legislation to this effect be
introduced prior to January 1, 2008.  However, the Legislature
intends that parties who are interested in the scope of practice of
optometrists commence negotiations on any proposed changes to the law
governing this practice no later than January 1, 2007.
